Preparing for radiotherapy: Use of micro-enemas

Supplement information to Radiotherapy information leaflet

1. Introduction

If you have been given this leaflet, it is thought that your treatment could benefit from you using a very small enema, called micro-enema.

This instruction leaflet will show you how to use the micro-enema. If you are worried that you will have problems with the process, please discuss your concerns with your radiographer.

2. How to use a micro-enema

A micro-enema is a method of helping your rectum to empty, causing a small bowel movement or passing of wind. It should feel similar to your normal sensation of needing a bowel movement and be under your control. A micro-enema should be used even if you have already emptied your bowels that day.

The medication for the micro-enema comes in a small tube with a nozzle (see picture).

These micro-enemas are safe to use unless you or you have an inflammatory bowel disease, such as Crohn’s Disease or are allergic to any of the ingredients. These are:

• sodium citrate
• sodium lauryl sulphate
• sorbitol

If you think you this may apply to you, please discuss with the radiographer at your radiotherapy planning scan appointment.

To use, you will be asked to go to the toilet and do this yourself:

1. Remove cap
2. Squeeze the tube a little to get a drop of liquid and spread it over the nozzle – this makes it easier to insert
3. Gently insert the nozzle fully into your rectum (back-passage)
4. Squeeze the tube to put all the contents into your rectum
5. Keep squeezing as you remove the nozzle – this stops the contents being pulled back into the tube
6. Dispose of tube in the waste bin with yellow or yellow/black stripped bag provided (not hand towel bin – clear bags)
7. Wash and dry hands
8. Return to the waiting room or walk around while waiting for the micro-enema to take effect

The need to have a bowel movement is usually felt within 10-15 minutes, with most patients needing to visit the toilet only once. You may only pass wind. If you feel the need to try to empty your rectum before 10 minutes, try to hold it if possible for the full 10 minutes. Do not worry if you can’t. If you have not felt the need to empty your bowels after 15 minutes, please try to do so, but please don’t strain.

Before your radiotherapy scan or treatment, please empty your bowel as often as you feel the need to do so.

If your rectum is already empty, the micro-enema will have little effect. If this is the case, please do not be concerned.

3. When to use it

You will need to use the micro-enema before your radiotherapy planning scan and before each of the first 10 treatments.

You will be asked to self-administering one micro-enema a day for the two days prior to your radiotherapy planning scan, when convenient, and then again for each of the two days prior to starting radiotherapy. A supply of micro-enemas will be given to you.

Please bring two tubes each day. If you forget to bring with you, just ask a radiographer and they will help you.

Please arrive 45 minutes before your appointment times. From the other information sheet given, you will see that you need to have a comfortably full bladder for treatment. Often when people empty their bowels, they will need to empty their bladder also. The order should therefore be:

1. Please arrive 45 minutes before your appointment times.
2. Use the micro-enema
3. Empty your bowels
4. After bowels empty, empty your bladder again
5. Follow drinking instructions

For any questions, or if you have any concerns, just ask your radiographer.

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.